New study reveals extent of race-based differences in death rates across U.S

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Demographers and health policy experts have long known that mortality rates in the U.S. differ depending on location, race, and ethnicity. Now a new study of two decades of mortality data from thousands of counties highlights the extent of those disparities.

A team of researchers used data from the National Vital Statistics Center and theNational Center for Health Statistics to estimate mortality rates from 19 causes of death across five racial and ethnic groups from 2000 to 2019. The data came from 3,110 counties nationwide.

The results showed race- and ethnic-based disparities in mortality virtually everywhere across the country. This was particularly true for American Indian/Alaska Native (AIAN) and Black populations, which experienced all-cause mortality rates of 1,028 and 953 per 100,000 respectively, compared to 442 per 100,000 in the Asian population, which had the lowest rate.

Cardiovascular diseases and neoplasms were the leading and second-leading causes of death, respectively, both overall and for every racial-ethnic group. The only cause of death that was highest among the White population was neurological disorders, making it the third leading cause of death overall and for all racial-ethnic groups except the AIAN and Black populations. The White population also saw a higher death rate than the Black population for chronic respiratory diseases, which was the fourth leading cause of death overall.

The study found that mortality rates from some causes of death were substantially higher among certain racial-ethnic groups than others. For example, Black Americans had a mortality rate of 8.9 per 100,000 due to maternal and neonatal disorders, compared to 4.2 per 100,000 among the AIAN population and 3.4 per 100,000 among the Latino population.

Similarly, the AIAN population’s mortality rate for digestive diseases of 86.2 per 100,000 was more than double the white population’s rate of 35.5 per 100,000 and the national mortality rate of 34.5 per 100,000.

“The consistency of these patterns strongly suggests shared root causes and highlights the widespread, perpetual, and negative impact of systemic racism on health,”Laura Dwyer-Lindgren, Ph.D., aassistant professor at the Institute for Health Metrics and Evaluation at the University of Washington and the study’s lead author said in a news release.

Large race- and ethnic-based disparities in mortality rates were also apparent on the county level. For example, the mortality rate for maternal and neonatal disorders was 14.8 per 100,000 in Champaign County, Illinois, compared to 1.2 per 100,000 for the white population of Arlington, Virginia.

Mortality for Asian and Latino populations, both nationally and in many counties, was lower than among whites for most causes of deaths. The authors speculate this may be due to the impact of migration, since about two-thirds of the Asian population and one third of the Latino population living in the U.S. were born elsewhere, compared to 13.7% of the population overall.

Reasons for the lower mortality rates include people in good health being more likely to emigrate than those in poor health, and differences between foreign-born and U.S.-born people in health factors such as smoking prevalence. The authors caution that the lower mortality rates among Asians and Latinos “should not be construed as indicating that these two populations do not experience or are not harmed by racism, as there is plentiful evidence to the contrary.”

The study, “Cause-specific mortality by county, race, and ethnicity in the USA 2000-2019: a systematic analysis of health disparities” was published online August 3 in The Lancet.